Every show with a suicide now has a disclaimer with a suicide hotline at the beginning. Is there any evidence that these warnings make a positive difference?
Suicides can be really easy to prevent.
Like, the hotline itself is incredibly effective, and reminding people it exists would naturally help.
People aren’t getting the number from the intro, but it reminds them it exists.
Even though crisis hotlines are common, they have not been well studied for efficacy.
Somewhat related, but I think suicide hotlines can be a big problem if they are understaffed. I feel like in my country they are just there to check a box. I’ve had two suicidal crises, both times I called the hotline, waited 20+ minutes and gave up. It made me feel even worse and more lost.
:( I’ve been in a similar situation, but I’ve never called; I have friends that I can talk to openly about this stuff, and not freak them out or have them be judgemental. I don’t know you, but I hope you are doing better, and can persevere. Life can be awful, brutal. Being alone in a time of need is… I can’t even think of a word with enough emphasis.
If you want, you can send me a message. Might not be helpful, but maybe it will. Just say hi, if you want. You aren’t alone. :)
Idk, but I bet they think it’s the least they can try. If it saves just one life, it has been worth.
Yeah it’s like a 0 effort thing to try
Except it’s not zero effort, zero cost.
Pretty much is in reality. But not literally zero, no.
It’s a job creator, so in effect it makes money.
/s
But do we have evidence they’re effective?
It still takes effort/time/money to do this, and if it has no impact, then that effort/time/money could be used on things that are known to be effective.
I have no idea how much effect they have. It’s possible they have a negative effect.
Op’s question is do we have that information?
How much effort/time/money do you think they put into that white text on black background that’s on screen for like 5 seconds?
It’s negligible, I would be shocked if it wasn’t the same recycled card over and over again that they have some unpaid intern throw in at some point in the final editing stages
It would probably cost more effort/time/money to do a study on its effectiveness than the pre roll does many times over lmao
I struggle with suicidal ideation problems. They have been so severe in the past that I almost went through it. While not all suicidal scenes trigger me, there are a few. And I have found that having the warnings help me from shutting off the TV and running off in a crying fit. I know it’s coming and can prepare myself. And knowing that the hotline is there has been one of the most comforting things I know of. I may have never called, but it’s there for when I can’t deal on my own. So yes, the warnings make a positive difference for me.
It’s amazing how effectively just hearing this from someone who has firsthand insight can put it in perspective.
And yet this thread is full of comments both confidently and cynically proclaiming that it’s totally useless and only there for the lawyers yada yada
The worst about ideation for me is that a few days/weeks/months later, I’m almost always thinking “I was willing to do that? Because of XYZ? That would’ve been so fucking stupid!”
But in the moment your brain can just be like “topping yourself is clearly the only logical solution” and make you actually believe that shit.
It’s wild.
Sorry, I realise this is a bit off topic.
Funny the fictions we contrive for ourselves in our own heads.
There’s a real need to get ones world view/beliefs and the insecurities and inner critics in line in order to survive it seems.
That’s my latest conclusion, anyway. Distraction and drinking haven’t really helped. Shocking, I know…
I’ve said this elsewhere in the thread, but I have had suicidal ideation… ‘events’ as well, never called though. If you want someone to talk to (anyone else, too! yes, that means you, hi!), reach out and message me. I know this shit all too well and I don’t mind in the slightest, talking to someone who needs - or just wants - to communicate with someone who ‘gets it’.
No pressure, I just want to help others like myself.
It is well appreciated.
I’m OK (now? currently? hopefully forever) but when I’m struggling I too appreciate the warning.
I’ve lost too many people in my life to suicide, and it’s a really hard topic for me to watch on screen.
So even though I’ve got no use for a hotline, just knowing that the show will center suicide as a theme is important to me being able to decide if/when to watch it.
No. It it makes normies feel good for trying
Definitely better than the YouTube approach and just make people call it suiclide, so no one really knows that they can kill themselves
Agreed.
Legend is the first suicide hotline was created after a girl killed herself because she had her first period.
People kill themselves for lots of reasons, but some of those reasons are just ignorance. I feel certain any suicide hotline could have helped her out if she’d called one.
I never would have remembered the old number, I believe they changed it to just 988 now. If making it an easy to access more memorable number that we grind into everyone’s brains and saves 1 extra person, it’s worth it. Hopefully it will save many who would have otherwise not been in the mental mindset to look up the help line
This makes sense to me. Suicidal ideation has been one of my PMS symptoms since I first started getting my period, and I’m not actually suicidal.
Yuuuup, I ended up getting a tattoo on my wrist that is essentially a personal period joke.
At one stage it was crucial for my survival, it was a kind of grounding token to snap me out of hormonal suicidal insanity when my PMS was at its worst. Something I’d see that would bluntly remind me “it’s not you, it’s your hormones, you don’t actually want this”
When I say the urge came and went zero to sixty back to zero in 30 seconds flat, sometimes that was an understatement. I really struggled because in addition to suicidal ideation during PMS, I had undiagnosed and untreated ADHD, which often gets worse with PMS thanks to the way oestrogen and progesterone play off each other.
Guess who’s got major impulsively issues. Guess what two symptoms really shouldn’t be combined.
I have zero desire to kill myself.
But my hormones seemed desperate to try and make me do it every month, especially as a teen.
It didn’t help that I had endometriosis and at 17 developed a uterine prolapse, on top of a rectal prolapse I’d had since I was 12. I was in agony when I was on my period, so sometimes the desire to make the pain stop overlapped with the suicidal ideation. That sucked. Hard to reason your way out of physical pain.
I’ve had a hysterectomy (from 17-24 my uterus just kept trying to make its own escape anyway despite attempts to sew it in place) and no longer suffer menstrual dysphoria because it turns out that was gender dysphoria not true PMDD. But I still get suicidal ideation as part of PMS, fortunately my ADHD is much better managed so now my tattoo is less a suicide detterant and just a reminder that I still have ovaries (sometimes I genuinely forget, and it takes me a few days to work out why I’m bloated and irritable and why I’m anxious about my sore boobs)
Warnings are great, sometimes I’m not in the right head space to watch those kind of scenes. I usually just don’t watch the episode until I feel it won’t affect me. This is also why doesthedogdie is a very useful resource for me
It’s really about not being sued by someone’s family for claiming that they got the idea from the show.
Oh please, there are hundreds if not thousands of stories about suicide out there and they don’t have warnings
Stop being so overly cynic, trust me, it’s not as edgy as you think it is
It’s notable that you needlessly made this personal…almost as if you existed at trump levels of projection.
Having more experience than you in a topic does not mean projection
You know nothing about me yet chose to make it personal twice. This is too strange.
Nothing here is about you bud… Self centered much?
I’ll just stop feeding the attention hungry hippo
Sorry but you don’t get to walk in, behave badly, and blame the other person. That’s just toxic. Have a block.
No idea, but I thought this would be a good time to share that teen suicide attempt rates spiked almost 30% in the month following Netflix’s 13 Reasons Why. It’s a pretty bad show, so of course it got 4 seasons.
TBH, I think that’s why shows have this now. Fear of legal liability.
There’s evidence that trigger warnings actually worsen anxiety and are counterproductive
The way to treat anxiety is to face the source of anxiety to try and change your relationship and reaction. The best way to do this is via controlled access that exposes one to the trigger gradually in a context that has no risk of harm (eg a media depiction, discussing the concept, building up to discussing the source of trauma that led to the phobic response if applicable)
Trigger warnings enable active avoidance. This sensitizes one to the aversive stimuli and makes the phobic response stronger. As a result when one encounters the stimulus (eg a friend, family, celebrity etc commits suicide, suffers an eating disorder, etc) your resilience to the trigger is now even lower and the response is more likely to be more significant than it was before.
That said education on access to resources like 988 or other warm lines can lower suicide rates, maybe. Research is more mixed here because it’s difficult to prove causation
There’s evidence that trigger warnings actually worsen anxiety and are counterproductive
I’d be interested in seeing these studies.
The way to treat anxiety is to face the source of anxiety to try and change your relationship and reaction. The best way to do this is via controlled access that exposes one to the trigger gradually in a context that has no risk of harm (eg a media depiction, discussing the concept, building up to discussing the source of trauma that led to the phobic response if applicable)
Trigger warnings enable active avoidance. This sensitizes one to the aversive stimuli and makes the phobic response stronger. As a result when one encounters the stimulus (eg a friend, family, celebrity etc commits suicide, suffers an eating disorder, etc) your resilience to the trigger is now even lower and the response is more likely to be more significant than it was before.
These two paragraphs seem to contradict each other. Controlled access in a safe setting like a media depiction sounds great. That’s exactly what trigger warnings are for. How can you possibly do controlled exposure without knowing if the content is there or not?
Trigger warnings enable active avoidance.
Incorrect. Trigger warnings inform you that the content is present in the media you’re about to watch. What you do with that information is up to you.
Thank you.
A big part of why I have severe anxiety to this day is because I was exposed to traumatic things far too young/quickly. I was pushed into situations where I was not ready or emotionally/mentally equipped to handle. Constantly.
Exposure is only good if a person is ready for it. Desensitization is only helpful when you are equipped to handle such a thing.
I had an ex who would say that we were doing one thing, then take me to do something completely different, then boast that he was “helping me”, which only heightened my fears in the end. As a foil to that, I had an ex after that who was encouraging and supportive and kind, and gently led me into the same situations, where I knew what I was getting into. Guess how which one had me overcoming my fears?
Exposure works best if you are prepared for the exposure and have the support you need in those kind of situations.
I am always thankful for trigger warnings.
https://journals.sagepub.com/doi/10.1177/2167702620921341 - the bigger takeaway from this one is that trigger warnings reinforce trauma as a central part of the traumatized individuals identity but they did find some incidence of drawback/harm
https://journals.sagepub.com/doi/10.1177/21677026231186625 meta finding no benefit and actually can cause an anticipatory reaction making the person more engaged with the material
There are others, this is just what grabbed from 30 seconds on google scholar. Its been a bit since I’ve done more serious lit review and it’s not like I keep a directory of papers I’ve read
The issue is the culture surrounding trigger warnings. Let’s be real here, people looking for trigger warnings are generally (perhaps overwhelmingly) not looking for material to help with their exposure therapy. They are looking for a “warning” to help them screen material to avoid. The issue is that this creates an unrealistic expectation that is incompatible with the real world. You can avoid suicide, sexual assault, eating disorders, or whatever in your media (maybe) but real life won’t sanitize itself or warn you. You will encounter these topics, whether through the news, careless speech from friends, or even intrusive thoughts of your own. Research continues to show that avoidance of upsetting topics can worsen anxiety and ptsd symptoms
To your final point the idea of it helping to create a choice isn’t even as clear cut as you describe
https://journals.sagepub.com/doi/10.1177/21677026221097618 content warnings actually increase the likelihood someone will view problematic content. This point is further reinforced by similar findings in the meta linked above
So you have a system that ultimately makes creators feel like they’re doing something noble, that is likely at best useless and potentially harmful. Said system increases the likelihood that a person will view the problematic content but also enables the reality that a person will simply avoid the things that provoke their anxiety which again is more strongly established as harmful
https://www.sciencedirect.com/science/article/abs/pii/S0005796712001064 - ptsd worsens with avoidance
https://www.sciencedirect.com/science/article/abs/pii/S0962184904000290 - anxiety disorders do the same
One tricky thing here is that existing literature is really examining the potential effects of trigger warnings in and of themselves, devoid of context or non-immediate decision making. Does seeing a literal trigger warning make someone feel less anxious? Almost certainly not, why on earth would it?
In studies that find no or slight negative effect, the outcomes are immediate measures. How do you feel right now? If it assesses decision making, it’s whether you do or do not immediately consume the content.
But for trauma survivors the potential to be triggered is always in flux, always dependent on everything else going on in your life, often set off by things that seem unrelated or irrational. Trigger warnings give someone a choice in that exact moment for what to do based on what they believe they can* manage. Yes, it may promote avoidance, but avoidance can increase feelings of agency that allow for reduced avoidance behavior in the future.
As an example from the great college campus syllabus trigger warning kerfuffle: I assign chapters from Durkheim’s Suicide in some seminars, as well as complementary readings with less obvious titles. My students get a warning about this ahead of time, but they don’t get to just skip that part of the class. Some things students have done: scheduled extra therapy sessions during those weeks, read in small groups in the library instead of isolated in dorm rooms, missed a class meeting and made up for it with office hours and a short additional assignment (so they didn’t out themselves to their peers with a panic attack in class). It’s about agency and self-assessment.
A screen with a suicide hotline number isn’t going to magically make someone ok with seeing suicide represented, but it offers an action the person can take to regain agency.
*Or just want to manage. Sometimes you’re just living your life and not super in the mood for exposure therapy, and if you can get your brain somewhere else for a while that’s a very good thing.
What do you propose as the solution, then? Without any up-front disclosure of the triggering content being present, how can anybody make the choice whether or not to expose themself to it?
Based on what I’ve heard about the US’s 988, it may rather be negative.
Oh, you’re thinking of killing yourself, let us reinforce that by being absolutely rude, or better yet, time to get taken away by cops into a psych ward.
Let’s see what’s out there with some example (Reddit)
Summary: Person called 988, police showed up 90 minutes later, got taken for mandatory psychological evaluation, forced to stay 2 days in ER, ended up getting billed $6,470.I think this kind of anecdotal horror story exists in every country, but of course it’s not the usual outcome.
There’s a whole chain of people involved in a process like this, and I have a hard time believing that everyone in that chain routinely locks up healthy people just to give themselves more work to do.
I think it’s far more likely that there are many people who genuinely should spend a few days in a psych ward but are unable to due to a lack of resources.
The bill is a fairly unique U.S. thing.
This isn’t anecdotal. It’s really quite a common response that only further traumatizes the victims and leaves them with a financial burden.
This is really reductive and doesn’t really consider how complex these situations can be.
What should police or first responders do when someone is at risk of harming themselves or others?
Whatever your answer, consider that the person is already having a bad day, and there are no on the spot cures for what ails them.
Hospitals in general are not nice places to be, as a patient. If you’re there for a physical illness it’s still traumatic.
You don’t go there to have a nice time, you go there to avoid the worst outcomes, like death.
I am certain that there are very, very few instances where people end up in a psych ward when there’s better places for them.
People are there because their lives suck. Traumatizing them and putting them in debt just makes the suffering worse. Putting them through this process DOES NOT help them.
Sorry mate, this is just plain wrong.
People are there because they have complex medical conditions which require specialist personnel and facilities.
Yes it can be scary and expensive, but it’s the best way to manage a shit situation.
If you are experiencing psychosis, then this will absolutely help you. If you are suicidal, it will not.
I remember my college had a suicide awareness day where among other things they told people to tell their suicidal friends to call the hotline if they felt suicidal.
Now imagine you are that person and you reach out to a friend for help only to have them tell you to call someone else in a canned speech you were told to tell others.
Feeling suicidal usually isn’t something that talking to a friend can resolve.
Getting a suicidal person to access the right kind of help is the right move.
That doesn’t mean you refuse to talk to a suicidal person, it means that part of supporting them as a friend is helping them get help.
Also as someone who spent a lot of time when I was younger as an untrained suicide counselor, it’s rough on you. Suicidal people should reach out to friends, but understand that if your friends aren’t able to help or keep boundaries there it’s not you, it’s not you being a burden, they may love you very much, but they need to engage in self preservation and the experts have better coping mechanisms, are in therapy, and have professional distance. Being an untrained suicide counselor was both a form of self harm and working through my trauma. I did real good for others and I don’t really regret it, but if you’re feeling the urge to do it, either get trained or get therapy, ideally both. I did later get trained in a form of counseling relevant to my traumas and I’m still comfortable doing that, but suicide counseling is rough at the best of times like being an emotional emt. And like emts they want to get to you in time to help, so if you need them use them, but the untrained are more like first aid, they can keep you around until an emt can get you to a doctor.
Serious question: How do you tell someone suicidal that opens up to you, that you can’t handle the topic without making them feel worse?
“I care deeply for you and that’s why I’ll acknowledge I can’t give the help you need. You need an expert not just a friend, and I can’t hurt myself helping you”
I don’t think it’s about making a positive difference, it’s about liability.
I don’t doubt that someone might be thinking that, but I do doubt that any lawyer thinks it’s necessary. As far as I know nobody has ever brought suit against a TV show for a suicide case.
But I’m not an attorney.
I’m pretty sure that 13 Reasons Why show had a whole thing involving just this
I would never call one.
Hopefully it’s because you’d never need one
And I have called one. Nothing wrong with needing help
